Colonscopy...won't say "never again" but..probably never again

Specialties Gastroenterology

Published

Had colonoscopy 3 days ago..My scope was performed because of a family hx of colon ca and a positive hemoccult card - just one. In retrospect I should've requested to repeat the cards x 3 first. My scope was normal - nothing found. I used mag-citrate to prep and skipped the moviprep- for one, I wasn't about to drink all that fluid when there was a way just as effective w/o taking all that in, nor was I going to pay $60 co-pay for the stuff.

I am still feeling the effects of the meds (Versed and Demerol), as well as bloating, nausea, slight cramping abdominal discomfort that borders on pain. I am not a "wus" by any means but for me, at least, this is not one day of prep and that's the worst of it. The prep day wasn't enjoyable obviously, neither was the day of the test, but I must give credit to anyone who undergoes one and is able to go back to work the next day. I feel like I have been hit with a ton of bricks and almost as though I have the beginning of the flu (which I don't).

I am not trying to discourage anyone from having one..just don't assume it will be as easy as the doctor makes it sound getting back on your feet.

Specializes in ICU.

I had my colonoscopy with propofol; I would not want versed and Demerol for it. I did have to drink a gallon of Golyte, which was upsetting because some doctors only order the mag citrate and a few dulcolax tabs. I had 10 polyps, but only one was pre-cancerous. I do not understand why my patients are so reluctant to do the prep; just one little evening out of your life, just might save your life. And why is it embarrassing? Nobody is going to stare at your bottom.

Specializes in Vent patients, OR.

hmm...well. Being an RN who just completed a year of Stage 3 colon cancer treatment...which started less than a month after I turned 40...and knowing that I will be getting waaay more than the usual number of colonoscopys...I can say there is a lot that is worse. And a lot that is more embarrassing. Six weeks of tomotherapy and concurrent chemo wrecks you. The radiation causes a diarrhea that likes to strike about a minute after you pass the last gas station. I took a change of clothes everywhere. The first couple of weeks with an ileostomy...ish. Nothing like being at the optometrist and realizing a leak has started (Eakin seals, people. The wonder solution.) My colonoscopy was with a GI tech I knew from working in the OR...just what everybody wants at their colonoscopy...someone you know. It ended up being a blessing because I too woke up when the GI MD was talking and said, "Mass highly suspicious of cancer". I can still see my friends face, her beautiful eyes with all of their concern, helping me to settle back down while the RN loaded me back up. The first days after ostomy reversal...OMG. THAT is embarrassing. When you know ALL the residents and RNs and have to call them to help you because you couldn't make it up to the bathroom in time...and there is poo on you and on your bed and your gown and the floor...Having your friends in PACU being the ones who clean you up after your LAR and your epidural has failed and you need a new one...so you are sent to PACU where your friends find out that the floor hasn't cleaned you up or turned you for the 24 hours after surgery. Well, at least at that point you know who your friends are as they hold you while you cry after they clean you up. And yeah...six months of FOLFOX makes you feel a lot worse than some versed. Laying there at 2am with that little pump whirring away, wondering if it's going to work, and, if it does, will it be back?

We do have a family history of colon cancer, but as a group of cousins, I was the "healthy" one...another, age 41, went for a colonoscopy because of me, and had a precancerous set of polyps removed. I am sooooo happy that my experienced saved her.

There is nothing about a colonoscopy that is worse than colon cancer. Nothing.

That said, I'm quite a libertarian. Make your own decisions, do what you choose. Be able to live with your decisions.

hmm...well. Being an RN who just completed a year of Stage 3 colon cancer treatment...which started less than a month after I turned 40...and knowing that I will be getting waaay more than the usual number of colonoscopys...I can say there is a lot that is worse. And a lot that is more embarrassing. Six weeks of tomotherapy and concurrent chemo wrecks you. The radiation causes a diarrhea that likes to strike about a minute after you pass the last gas station. I took a change of clothes everywhere. The first couple of weeks with an ileostomy...ish. Nothing like being at the optometrist and realizing a leak has started (Eakin seals, people. The wonder solution.) My colonoscopy was with a GI tech I knew from working in the OR...just what everybody wants at their colonoscopy...someone you know. It ended up being a blessing because I too woke up when the GI MD was talking and said, "Mass highly suspicious of cancer". I can still see my friends face, her beautiful eyes with all of their concern, helping me to settle back down while the RN loaded me back up. The first days after ostomy reversal...OMG. THAT is embarrassing. When you know ALL the residents and RNs and have to call them to help you because you couldn't make it up to the bathroom in time...and there is poo on you and on your bed and your gown and the floor...Having your friends in PACU being the ones who clean you up after your LAR and your epidural has failed and you need a new one...so you are sent to PACU where your friends find out that the floor hasn't cleaned you up or turned you for the 24 hours after surgery. Well, at least at that point you know who your friends are as they hold you while you cry after they clean you up. And yeah...six months of FOLFOX makes you feel a lot worse than some versed. Laying there at 2am with that little pump whirring away, wondering if it's going to work, and, if it does, will it be back?

We do have a family history of colon cancer, but as a group of cousins, I was the "healthy" one...another, age 41, went for a colonoscopy because of me, and had a precancerous set of polyps removed. I am sooooo happy that my experienced saved her.

There is nothing about a colonoscopy that is worse than colon cancer. Nothing.

That said, I'm quite a libertarian. Make your own decisions, do what you choose. Be able to live with your decisions.

I wish you all the best. I didn't want to read and run...your post really touched me.

Specializes in ..

Outstanding post JRN72! Just got hired as NP for GI practice and this post is just what I needed to read. Best wishes and thanks a million!!

Not to be sarcastic, because I do take health seriously, but the odds are pretty good. According to the CDC, a 50 year old man has only a 1.9% chance of developing colon cancer in the next 20 years....that's 98% that won't.

CDC - Colorectal Cancer Risk by Age

Since I have been scoped twice, I would think it safe to say my personal odds are likely less.

I have come to the conclusion that this particular procedure and many other preventative procedures are over done in this country. There is a strong profit incentive to keep everyone scared that they might possibly have an undetected cancer.

Certainly lives are saved by colonoscopies. Every once in a while a symptomless cancer is found and removed successfully. That's a good thing. But many many more people are put through a very humiliating and painful procedure, often scared to death of what might be found. In my case, each time a millimeter scale adenomatous polyp was found. Perhaps these could have developed into cancer....some do....but the fact is that something like 20 - 30% of people over 50 have polyps...and the vast majority never present any danger.

People should get screened if they really feel that they want to know...with a full disclosure of what the odds really are, what the experience is really like rather than having a doctor harping on you that your life is at great risk if you don't get screened.

While I have incredible respect and admiration for medical professionals and have been well taken care of by some wonderful nurses...please don't assume it's a comfort to those of us with modesty issues to say something along the lines of "I see hundreds a week and it doesn't do anything for me." OK, I get it, seeing my private parts is no big deal for you. That's fine, you are comfortable with it....this kind of statement only goes to what your feelings are as the caregiver. It does absolutely nothing to alleviate the embarrassment and humiliation I feel when asked to expose myself. No big deal for you...it is for me...and having you tell me it is no big deal only dehumanizes me somewhat as if my feelings don't matter at all. A lot of medical professionals...well meaning I'm sure...use this kind of statement. Please rethink that, it is not comforting in the least and doesn't help.

Again, I'm not likely to comply with my doctor's wishes to have me do this again in a few years. To me it was humiliating, I woke up during the procedure even under propofol and I felt like I wasted my time, my insurance company's money and my doctor's time that he could have used treating patients who actually did have a problem in that area.

That said...I do highly respect the people in this profession and on this board and thank you for all that you do.

My DH had the exact same attitude as you...

Until he was diagnosed with stage III rectal cancer at age 47, after having had a similar polyp to yours in the past that he blew off as never going to happen again or certainly not high enough odds to be a problem later. 7 years after refusing to follow up, he began noticing some blood in his stool. He sure lost the arrogant attitude when he had to go through radiation, get an ileostomy, and endure 8 months of IV chemo. He is glad to be alive, but his anatomy has been forever changed (in spite of successful ileostomy reversal) and his "plumbing" causes him no end of aggravation. It's unpredictable and interferes with his personal and professional life.

Embarrassing and uncomfortable? Sure, but nothing compared to cancer. Talk about humiliating-try imagining a life with an ostomy.

I had mine last week, and I admit that the whole thing was a beating. Don't regret it a bit as they found a very large polyp. It's gone, and I'm going to be fine, but am waiting on pathology to tell me when I have to go back. I'll do so happily as I DON'T want to go through what my husband did. I DON'T want to wait until I actually have cancer to treat it-I prefer to use this technology to prevent it, period.

As to waking up while getting propofol-that never happens in our facility, and we do 40-55 cases A DAY. Your provider failed you, imo.

Specializes in kids.

For me the prep was piece of cake (well no, not that good!) I did the gallon, put the mixture in 16 oz glasses in fridge and went full steam ahead each time I need to drink.

Recovery, That SUCKED...I am really sensitive to narcs and remember waking up, feeling ok, so they gave me a mufffin...not five minutes later the nurse (who was awesome!!!) took one look at me and said "I'll take that now" and whipped out an emesis basin which I proceded to use...for hours.......not a good day...I think three people came and went in the bed beside me in recovery.....finally at 430 PM she leaned over and said "you don't have to go home, but ya cant stay here!!!!" They loaded me up with 2 liters of fluid asked me if I had someone at home. I lied and said yes, they called my ride, who got me into bed, put the phone next me and left at my request.

All I wanted was to be in the fetal position in my own bed....around midnight (some 12 hours after) I started to feel human again. And the next day I was fine! I do remember her saying that the next time they would pre-medicate me with a lot of anti nausea meds.

But they did grab a polyp and fortunately it was negative!

I think it would be really irresponsible not to have a Colonoscopy again. It does suck that you experienced a great deal of discomfort, it happens, but that shouldn't discourage you from getting another one... especially considering with a family hx and normal results, you generally only have to get every 5 years.

Potentially getting Colon cancer vs a few days of discomfort. Hmm..

Not to be sarcastic, because I do take health seriously, but the odds are pretty good. According to the CDC, a 50 year old man has only a 1.9% chance of developing colon cancer in the next 20 years....that's 98% that won't.

CDC - Colorectal Cancer Risk by Age

Since I have been scoped twice, I would think it safe to say my personal odds are likely less.

I have come to the conclusion that this particular procedure and many other preventative procedures are over done in this country. There is a strong profit incentive to keep everyone scared that they might possibly have an undetected cancer.

Certainly lives are saved by colonoscopies. Every once in a while a symptomless cancer is found and removed successfully. That's a good thing. But many many more people are put through a very humiliating and painful procedure, often scared to death of what might be found. In my case, each time a millimeter scale adenomatous polyp was found. Perhaps these could have developed into cancer....some do....but the fact is that something like 20 - 30% of people over 50 have polyps...and the vast majority never present any danger.

People should get screened if they really feel that they want to know...with a full disclosure of what the odds really are, what the experience is really like rather than having a doctor harping on you that your life is at great risk if you don't get screened.

While I have incredible respect and admiration for medical professionals and have been well taken care of by some wonderful nurses...please don't assume it's a comfort to those of us with modesty issues to say something along the lines of "I see hundreds a week and it doesn't do anything for me." OK, I get it, seeing my private parts is no big deal for you. That's fine, you are comfortable with it....this kind of statement only goes to what your feelings are as the caregiver. It does absolutely nothing to alleviate the embarrassment and humiliation I feel when asked to expose myself. No big deal for you...it is for me...and having you tell me it is no big deal only dehumanizes me somewhat as if my feelings don't matter at all. A lot of medical professionals...well meaning I'm sure...use this kind of statement. Please rethink that, it is not comforting in the least and doesn't help.

Again, I'm not likely to comply with my doctor's wishes to have me do this again in a few years. To me it was humiliating, I woke up during the procedure even under propofol and I felt like I wasted my time, my insurance company's money and my doctor's time that he could have used treating patients who actually did have a problem in that area.

That said...I do highly respect the people in this profession and on this board and thank you for all that you do.

We currently have 4 clinics.... and on average we scope 15-20 patients a day. If we have two rooms running in one clinic we do about 38 procedures. I work as a GI tech, and you'd be surprised at the number people that come in simply for screening that have pre-cancerous polyps. It would actually be out of the ordinary to have one day where no polyps were found in any patient.

I understand the issue of feeling very uncomfortable. I would feel very embarrassed to get mine done as well, but then I realize that I'd rather be embarrassed for a short period of time then to potentially get cancer. We do get patients that come in that are extremely embarrassed, but I do everything in my power to make them feel more at ease.

It's not a waste of time, just like ALL forms of screening, there is a good chance that you will have normal results..but there is a chance that you won't. You may never get a polyp, but why take that risk? My grandfather didn't get his colonoscopy done until he was about 65, because he didn't want to deal with the uncomfortableness of the procedure. But guess what? When finally felt the need to get it done (he had rectal bleeding and severe abdominal pain), he ended up being diagnosed with stage 4 colo-rectal cancer. He died shortly after. Don't think "it will never be you".

It is foolish not to get screen, regardless of the probability. Heck, working at this place makes me want to get a colonoscopy NOW, and I'm only 25. We had a patient that was MY AGE, come in with similar symptoms as my grandfather. The last thing anyone would have thought would be cancer. But she had it, and she went from being a young, lively woman to being on life support and then dying. While her dx was definitely an anomaly... since she didn't have FAP or any related condition, it goes to show that it can happen to anyone.

Specializes in ICU, Endo.

I totally agree about the VC's! I would rather do a prep and if there's a polyp, have it removed during the procedure, not at my next colonoscopy appt with a repeat of a la PREP! We have several docs, most love MoviPrep, one prefers SuPrep and another uses Miralax (which the patients love!). Some patients just feel more of the medication effects than others (we use fent/versed for most patients). I had an EGD the same day as my husband, same amount of meds and he had nausea, I didn't. I felt fine (sleepy, but not nauseous) and my hubby felt sick all day!

Specializes in ICU, Endo.

I am so sorry you had a tough time with your procedure, but I am truly glad you went. You never know what the next polyp could become, especially after 10 years! I can assure you the nurses don't focus on that end of your body! While you are having your procedure performed, the RN is focusing on your vital signs, charting, and making sure you are comfortable. In pre/post op, again, the RN wants to make sure your are passing air, vitals remain stable, and you are discharged in good shape, no nausea, and well educated about your procedure/discharge instructions/findings, etc. Please follow up with your GI doc when they contact you again! Preventative care is cheaper and more comfortable than chemo!

Just out if curiosity how much versed and fentanyl can b given by an RN during conscious sedation before anesthesia is asked to step in with propofol? And what would you say the average time is for colonoscopy procedures?

There is no magic number for moderate sedation drugs by an RN. Commonly 2 to 5 mg. versed, 100 mcg. Fentanyl, but there are many variables.

The best and fastest GI Dr. in the world can take 10 minutes on one pt., and 40 on the next. Bowels can be redundant, have large divierticuli, have adhesions, just be plain old "weird," and the scope won't pass easily. If there are many or large polyps that takes time.

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